Organization
MYSTIC MEDICAL ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER J ANDERSON MSN FNP-C (APRN)
(860) 245-4126
Entity
Organization
Contact information
Practice address
12 ROOSEVELT AVE, SECOND FLOOR, MYSTIC, CT 06355-2809
(860) 245-4126
(860) 245-4128
Mailing address
495 GOLD STAR HWY STE 112, GROTON, CT 06340-6229
(860) 245-4126
(860) 245-4128
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
06/27/2016
Last updated
03/21/2024
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